Provider Demographics
NPI:1225256258
Name:HARDY, CHARLOTTE A (MSW)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:A
Last Name:HARDY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-3423
Mailing Address - Country:US
Mailing Address - Phone:405-528-8705
Mailing Address - Fax:
Practice Address - Street 1:3601 N CLASSEN BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-3231
Practice Address - Country:US
Practice Address - Phone:405-525-2500
Practice Address - Fax:405-525-2544
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK03191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical